title: Orlistat after initial dietary/behavioural treatment: changes in body weight and dietary maintenance in subjects with sleep related breathing disorders.
abstract: BACKGROUND
  Sleep related breathing disorders (SRBD) are associated with increased morbidity and mortality and weight loss is recommended to overweight or obese patients with SRBD. However, maintenance of weight loss is difficult to achieve and strategies for weight loss maintenance is needed. Orlistat is a pharmacological agent that reduces the intestinal absorption of fat and may favour long-term weight maintenance.
  
  
  OBJECTIVE
  To examine the change in body weight and dietary intake during a 1-year treatment with orlistat after an initial weight loss in obese subjects with SRBD. Furthermore, to explore the dietary determinants of weight maintenance during treatment with orlistat.
  
  
  METHODS
  Men and women with SRBD aged 32-62 years (n=63) participated in a 3-month dietary intervention to increase intake of vegetables and fruit. After an initial weight loss of 3.4 kg they achieved a mean body mass index of 34.3±4.7 kg/m2. Subsequently they were treated with orlistat for 1 year. During this year, dietary and behavioural interventions to attain weight loss were provided in the course of 14 group sessions. Dietary intake, energy density and food choices were assessed with a food frequency questionnaire before and after orlistat treatment.
  
  
  RESULTS
  With orlistat, body weight decreased by a mean of 3.5 kg (95% CI 1.5, 5.5). The dietary E% from saturated fat, intake of fatty dairy products and energy density increased after 1 year while intakes of oils, fish and vegetables decreased (all P<0.05). After multivariate adjustments, weight loss was associated with E% protein (R2adj=0.19 [95% CI 0.10, 0.46]), and inversely associated with E% saturated fat (R2adj=0.20 [95% CI 0.12, 0.47]) and fatty dairy products (R2adj=0.23 [95% CI 0.12, 0.49]).
  
  
  CONCLUSIONS
  Orlistat induced further weight loss, but dietary compliance declined with time. Increasing dietary protein and restricting saturated fat and fatty dairy products may facilitate weight loss with orlistat.
authors.affiliation: Preventive Cardiology, Oslo University Hospital, Ullevål Hospital, N-0407 Oslo, Norway. mette.svendsen@uus.no
authors.forename: Mette
authors.initials: M
authors.lastname: Svendsen
authors.forename: Serena
authors.initials: S
authors.lastname: Tonstad
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001835:Body Weight; D004032:Diet; D005260:Female; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D008297:Male; D009765:Obesity / Q000188:drug therapy; D000077403:Orlistat; D010349:Patient Compliance; D012891:Sleep Apnea Syndromes / Q000188:drug therapy*; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat